What left him breathless is his damaged heart -- since repaired with emergency surgery after he waited for a transplant.

The air we breathe doesn't just make kids with asthma or seniors with emphysema wheeze. It damages our hearts, triggers heart attacks and leaves people with cardiac diseases, like Fridgen, struggling.

Research linking heart disease to tiny particles in the air has estimates of air-pollution deaths spiking.

The evidence is so compelling the Heart and Stroke Foundation warns high-risk people to avoid living near busy roads, where levels of fine particulate matter are highest.

"Many more people die of heart disease caused by air pollution than respiratory disease caused by air pollution," says researcher Dr. Stephan van Eeden, a spokesman for the foundation.

"There are many more people with heart disease than lung disease. If you have heart disease, you are more vulnerable to the effects of air pollution."

VICIOUS CELL CYCLE

In fact, smog is just as bad for your arteries as smoking, van Eeden says. They have similar effects on our bodies.

Researchers think tiny particles are breathed deep into the lungs where specialized cells "eat" the particles, but also cause inflammation. That sends a message to the bone marrow to produce more white blood cells, which circulate in the blood, attaching to the walls of blood vessels and causing blockages that trigger heart attacks or strokes.

Van Eeden took rabbits with the same genetic tendency to get atherosclerosis as people and put them in chambers full of fine particulate matter.

"The particles we used were collected over Ottawa," he says. "If you expose animals to these particles, the atherosclerosis was much worse. That concept has now been confirmed on a human scale."

Fine particulate matter triggers heart attacks in the short-term, too. A European study asked people where they were when a heart attack struck.

"The vast majority were in or on some major artery -- they were in traffic," van Eeden says.

"There's a strong association between being in traffic and having a heart attack. The evidence is slowly mounting. We can't ignore this anymore."

German doctors discovered that when fine particulate levels are high, heart attacks triple, while Japanese researchers found air pollution changes the way the heart beats.

The villain is fine particulate matter smaller than 2.5 microns -- 20 times smaller than a hair.

The most dangerous particles are even smaller -- the size of a virus. They're so small studies show they can go through the lungs into the bloodstream.

We're not safe even in our homes.

"You're not protected indoors from the really fine particles that go deep into your lungs and that are most dangerous," van Eeden says. "Indoors and outdoors, they're the same."

The medical community is waking up to the health effects.

Van Eeden applied for his first grant from the foundation a decade ago. He was turned down.

"The statement was, what does air pollution have to do with blood vessel disease?

"Now the paradigm has totally shifted. The same thing happened with smoking. It took years for us to discover smoking is very bad for you."

Many people still don't understand the link.

Van Eeden cringes when he sees people jogging along major roads. He advises patients with heart and lung diseases not to live near heavy traffic.

"Whether they can do it, or not, that's another question," he says.

"But you get that message out. If you have heart disease or lung disease you should not live in an area with heavy traffic. Maybe none of us should."

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